Study of use of pemetrexed in non-small cell lung cancer

Objective

To study the effectiveness and safety of pemetrexed in non-small cell lung cancer.

Method

Retrospective study (March 2006-May 2008) of pemetrexed use. Information was obtained from the Access database belonging to the Pharmacy and Oncology Departments, the registry of external consultations and clinical histories. Data were analysed using SPSS software version 12.0. Quantitative variables are expressed as the median (minimum-maximum).

Results

The study included 44 patients (61.7 [39–77] years old), mostly male (86%), smokers or former smokers (80%) with predominantly epidermoid/squamous disease (46%) or adenocarcinoma, in a good functional state (86%) and in stage ≥III upon beginning pemetrexed treatment (93%). Prior treatment with taxanes and taxane treatment along with a prior history of neutropoenia were the criteria for changing to pemetrexed in 34.4% and 22.7% of the patients, respectively. None of the patients presented a complete or partial response: 18.2% showed disease stability and 81.8% showed disease progression. The main reasons for discontinuing pemetrexed were progression of the disease (54.5%) and worsening of symptoms (15.9%). Median survival after beginning chemotherapy was 22.2 months (ranging from 16–28.4) and 7.8 months (4.4–11.2) after beginning pemetrexed treatment. These last figures were significantly higher in women and those with an ECOG of 0 to 1. The most common adverse effects were weakness and neurotoxicity.

Conclusion

In each of the cases, pemetrexed was used as a second-line treatment or higher with a good safety profile. A complete or partial response was not reached in any of the cases, but survival after beginning pemetrexed was equal to or longer than that achieved in other studies.